Online Referral Form

Please fill in the form below to setup an appointment.
Select Location*
- 150 East Manning Street, Providence, RI
- 1525 Wampanoag Trail, East Providence, RI
- 55 Village Square Drive, South Kingstown, RI
- 235 Hanover Street, #201, Fall River, MA
Reason For Referral
All information is stored securely and is HIPAA compliant
Referring Doctors Name*
First Last
Referring Practice Phone*
Patient Name*
First Last
Patient Phone*
Patient Email*
Comments
Email
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Why Refer?

Like you, caring for patients and their vision is our priority! Rhode Island Eye Institute has the training and technology to practice the fullest scope of optometry and ophthalmology. As a result, many doctors like you, including optometrists & ophthalmologists, primary care providers, pediatricians, and other professionals, refer their medical and specialty cases to our practice.

We treat all patients with the same respect and compassion we would seek for our own family members. A comprehensive referral report of our findings and treatment plan will be sent to you promptly. Rest assured that our mutual patients will be directed back to you for their primary care needs.

To learn more about the experience and services we provide to patients, we can provide a short presentation by our eye doctors. We will do our best to accommodate your office, and most discussions are scheduled during your staff meeting or lunch hour.

To refer your patient for expert care, you may:

Call us directly at

401-496-8652